TREATMENT-RESISTANT EPILEPSY AND TREATMENT-RESISTANT SCHIZOPHRENIA; A REAL CHALLENGE FOR THE PSYCHIATRIC TEAM

Treatment-Resistant Epilepsy and Schizophrenia

Abstract

Schizophrenia and epilepsy may exist together, but it is very rare to have a resistant form of both illnesses in one patient. We present a case report of a 49-year-old woman who was managed at our psychiatric facility suffering from treatment-resistant schizophrenia and epilepsy. She presented with suspiciousness, fearfulness and with a belief that people in the hostel wanted to harm her and were putting hair on her bed. She was also having recurrent seizures weekly due to her refractory epilepsy secondary to mesial temporal sclerosis. She was non-compliant with medication and refused surgical management of mesial temporal sclerosis. Whilst in the hospital was on five antiepileptic drugs prescribed by the neurology team and these control the seizures. Olanzapine and paliperidone depot was used for schizophrenia which had a partial response. Clozapine was not
considered in view of her severe uncontrolled epilepsy. Concerns were raised regarding her capacity to decide about treatment options. The possibility of an organic cause for both schizophrenia and epilepsy were considered.